Health organizations often have difficulty managing daily demands for services. A major disease outbreak or bioterrorism attack will gridlock the system. Accessa, with technical assistance from Ingham County Public Health Service (ICPHS), will develop and validate an outbreak response system intended to assist public health departments handle high call volumes and allay public fear. This rules-based Internet and interactive voice response system will disseminate information, automatically triage high volumes of citizen information requests, and assess the probability of exposure and transfer high-risk individuals for appropriate intervention. It will provide coded number, quality controlled and medically directed Internet and/or telephone two-way communication for test scheduling, results reporting to facilitate case management. In Phase I, Accessa will utilize interviews, questionnaires and Nominal Group Process sessions to conduct a needs assessment, complete system design and produce a prototype module on smallpox. The prototype module will be validated by separate focus groups made up of health officials and lay public. in Phase II, Accessa will construct a scalable system and conduct a statistically valid evaluation comparing ASR to current ICPHS response services, in a virtual event simulation. A framework for additional disease modules will also be constructed. A panel of recognized experts will review activities.